Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Huntersville Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
9622 KINCEY AVE, HUNTERSVILLE, NC 28078-9140
(704) 912-3890
(704) 948-1177
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851769848
—
NC
Enumeration date
09/08/2015
Last updated
02/02/2026
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